In total hip arthroplasty, the greater trochanter with its attached abductor musculature is often osteotomized from the proximal femur and retracted out of the way for access to the hip joint. After the femoral head is replaced with a prosthetic femoral component, the greater trochanter is relocated and fastened in place.
The surgical problem encountered is fixation of the greater trochanter to the proximal femur until the bone has had time to fully heal. Perhaps the most common prior art method is to wire the greater trochanter in position using various techniques. In use, the abductor muscle may apply substantial force to the wires, and this can cause the wires to be pulled through the bone against which it bears. Also, if the greater trochanter is not wired tightly in position, the force of the abductor muscles against the wire can cause migration of the greater trochanter. In either event, proper fixation of the greater trochanter to the proximal femur is not obtained.
Other approaches for holding the greater trochanter include the use of trochanteric mesh and various bolting techniques, such as those shown in Lee, et al., U.S. Pat. No. 3,939,498 and Grobbelaar U.S. Pat. No. 4,153,953. The bolting techniques do not employ wire, and the trochanteric mesh does not prevent wire from pulling through the greater trochanter.
Dall, et al., U.S. Pat. No. 4,269,180 shows a rigid H-shaped implant which has projecting teeth at its opposite ends. Wire can be passed through two holes in a web of the implant and through a hole in the femur. This device requires the placement of two of the teeth into the bone, and it has a rigid appearance that would apparently substantially inhibit its conformity to the configuration of the greater trochanter. There is also no provision for holding the implant in multiple directions using wire.